This information is provided by SSCHRC to help you understand Wilms' tumour and its management. It is written in a patient-friendly and medically accurate style.
Wilms' tumour, also known as nephroblastoma, is a rare form of kidney cancer primarily affecting children. When detected and treated in its early stages, the chances of a successful outcome are very high, up to 95%.
In India, Wilms’ tumour is the most common type of kidney cancer in children, with an estimated ~1,600 new cases diagnosed annually, mostly in young children under the age of five, and early diagnosis and treatment significantly improve outcomes.
The development of Wilms' tumour may begin before birth. Kidney cells typically mature into specialised components of the kidney in the fetus and continue to mature for a few years after birth. However, in children with this tumour, some cells remain immature, grow, and reproduce too rapidly, leading to the formation of a mass.
Typically, Wilms' tumour presents as a single tumour in one kidney, though in rare instances, a child may have multiple tumours in one kidney or tumours in both kidneys. Due to their rapid growth and lack of early signs, these tumours can be large when discovered, and may have spread to other areas of the body, most commonly the lungs.
Wilms' tumours are classified based on their appearance under a microscope:
This is the most common type. The cells show only slight abnormalities, and the prognosis for successful treatment is good.
In this rarer type, the DNA-holding area of the cells is large and distorted (anaplastic). These tumours are generally more challenging to treat successfully.
A risk factor is anything that increases your child's likelihood of developing Wilms' tumour. While the exact cause is unknown, certain factors may increase this risk. It is important to remember that not all children with risk factors will develop the tumour, and these should be discussed with your child's doctor.
Symptoms vary between children. As tumours often grow large before detection, the most common sign is a swollen or enlarged abdomen, where a noticeable mass may be felt.
Important Note: It is important to note that these symptoms are often caused by conditions less serious than Wilms' tumour. However, if your child exhibits any of these, we recommend consulting a doctor, as they may indicate another health issue.
Wilms' tumours are often quite large when first discovered, sometimes exceeding the size of the kidney where they originated. Thankfully, most are found before they have spread to other organs.
At SSCHRC, our world-renowned specialists take the time to examine each child carefully. Their high level of skill and expertise, supported by the latest diagnostic technology, helps to precisely pinpoint Wilms' tumours, which significantly improves the chances of successful treatment.
If your child presents with symptoms suggestive of Wilms' tumour, a doctor will conduct an examination and ask about your child's health and family medical history. One or more of the following tests may be used to confirm the diagnosis, check for spread, or monitor treatment effectiveness:
These tests create pictures of the inside of the body and may include:
A biopsy is usually necessary to diagnose Wilms' tumour. Since surgical removal is the primary treatment, the biopsy is often performed simultaneously with the surgery. However, doctors may sometimes remove cells for examination before the operation using one of these methods:
These tests help assess overall health and organ function, and may detect abnormalities that could indicate the presence of Wilms' tumour.
Your child's doctor will tailor a specific course of treatment, taking into account their age, overall health, and the stage of the cancer.
Wilms' tumour is almost always treated with a combination of therapies, most commonly surgery and chemotherapy. In some cases, chemotherapy or radiation therapy may be administered before surgery to shrink the tumour, making it easier to remove. If cancer cells remain after the operation, radiation therapy may be used.
The main objective of surgery is to remove the primary tumour as completely as possible. This typically involves removing the entire kidney, along with the adjacent ureter and adrenal gland, a procedure known as a nephrectomy. During the operation, nearby lymph nodes may also be removed and checked for cancer cells, and the surrounding organs and the other kidney will be examined.
Two types of nephrectomy are used:
If both kidneys need complete removal, your child will require dialysis (using a machine to filter the blood) several times a week. A kidney transplant may become an option later on.
Most children undergoing treatment for Wilms' tumour will receive chemotherapy. If the tumour is large, difficult to access, or if tumours are present in both kidneys, chemotherapy may be given prior to surgery to reduce the size of the tumours and facilitate easier removal. SSCHRC offers the most advanced chemotherapy agents.
Radiation therapy (also called radiotherapy) uses high-energy beams to destroy cancer cells. Through new techniques and remarkable skill, doctors at SSCHRC can target tumours with greater precision, delivering the maximum necessary radiation while minimising damage to surrounding healthy cells.
SSCHRC provides advanced radiation treatments, including:
As part of one of the world's premier cancer centres, SSCHRC is involved in numerous clinical trials (research studies) for Wilms' tumours, including studies from the Children's Oncology Group and unique trials found only at a few global institutions. These innovative treatments may represent the best treatment option for your child. For more information on clinical trials at SSCHRC, please speak to your doctor.
Wilms' tumours are rare, and many cancer specialists encounter few cases in their careers. SSCHRC's , as a component of one of the world's largest and most comprehensive cancer centres, offers a depth of expertise and experience rarely found in other hospitals.
This remarkable team includes renowned oncologists, surgical oncologists, radiation oncologists, and pathologists, all of whom specialise in the unique medical needs of children with cancer. They are supported by specially trained nurses, therapists, and other professionals who follow your child from diagnosis through to survivorship, continually monitoring their health and quality of life.
Surgical skill is paramount in treating Wilms' tumours. As with all surgeries, the procedure is most successful when performed by a specialist with extensive experience in that specific operation. SSCHRC surgeons are among the most skilled globally, with a high level of experience in Wilms' tumour surgeries, employing the least-invasive and most-advanced techniques. We are at the forefront of discovering groundbreaking treatments for Wilms' tumour, which translates into a wide array of clinical trials for children with the disease.